In the next 18 months PCPs and other physicians will be able to make referrals from their EHRs with a few clicks and receive feedback directly into their EHRs. This has big implications for behavioral health clinicians. Those without the ability to take an electronic referral may be in jeopardy.

The phone and paper referrals will not be completely supplanted, but the automated approach is likely to be adopted quickly because physicians want it and government incentives are driving it.

The government provides financial incentives to physicians for Meaningful Use (MU) of EHRs. Physician adoption of EHRs that qualify for these incentives is over 70% nationwide and higher in some places. (Massachusetts adoption is over 80%.) Part of the demonstration of MU is transmitting referral information electronically via a certified EHR. The MU standards are progressive. The changes being phased in 2014-2015 will make electronic referrals available to all providers using certified EHRs.

Although physicians complain many MU standards are bureaucratic hoops that don’t improve patient care, they are enthusiastic about features that help them share patient information. Surveys show that bilateral online sharing of clinical information, including referrals, is perceived by most physicians as actually improving patient care by providing clinically relevant information at the time of the referral.

Non-Medical behavioral clinicians are not eligible for MU incentives, but those who can receive electronic referrals and send back electronic clinical summaries (which can include custom text comments) and progress information will enhance their status with referral sources and become part of the virtual healthcare team.

Interoperation between EHRs has been a high priority for years. Now it is becoming a reality. Behavioral clinicians who participate will be able to come out of their silos and join the wider healthcare team.